Provider Demographics
NPI:1992173983
Name:SHAUBACH, CHRISTINE MARIE
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:SHAUBACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:SHAUBACH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, CCDP-D
Mailing Address - Street 1:32057 SUSSEX ST
Mailing Address - Street 2:
Mailing Address - City:DAGSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19939-3862
Mailing Address - Country:US
Mailing Address - Phone:302-381-2977
Mailing Address - Fax:
Practice Address - Street 1:32057 SUSSEX ST
Practice Address - Street 2:
Practice Address - City:DAGSBORO
Practice Address - State:DE
Practice Address - Zip Code:19939-3862
Practice Address - Country:US
Practice Address - Phone:302-381-2977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-08
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00013911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical